BACKGROUND: Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI), associated with a high mortality. A significant improvement in survival has been reported with immediate coronary revascularization. However, there is no clear evidence of such an improvement amongst older patients. The aim of our work was to evaluate in-hospital and long-term outcomes in the group of elderly AMI patients with CS (≥75 years old). METHODS: We collected data of 157 consecutive AMI patients with CS who underwent percutaneous coronary intervention (PCI) and compared clinical and procedural characteristics and in-hospital and long-term outcomes between patients <75 years and patients ≥75 years old. RESULTS: There were 58 patients (36.9%) with age ≥75 years and 99 patients (63.1%) with age <75 years. Patients were followed up for an average period of 34 months (range 5-69). In-hospital and long-term mortality was significantly higher in the older group (55 vs. 25%, P < 0.0001; and 62.1 vs. 37.3%, P = 0.005, respectively). Multivariate predictors of in-hospital mortality were age ≥75 years (hazard ratio 1.81, 95% CI 1.006-3.27, P = 0.04) and PCI failure (hazard ratio 2.67, 95% CI 1.34-5.307, P = 0.005), whereas, the only multivariate predictor of long-term mortality was PCI failure (hazard ratio 2.88, 95% CI 1.52-5.46, P = 0.001). Age ≥75 years showed only a trend toward statistical significance (hazard ratio 1.62, 95% CI 0.96-2.76, P = 0.07). CONCLUSIONS: In elderly AMI patients with CS, PCI can be performed with an acceptable risk that seems lower than that reported in most previous studies.
BACKGROUND:Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI), associated with a high mortality. A significant improvement in survival has been reported with immediate coronary revascularization. However, there is no clear evidence of such an improvement amongst older patients. The aim of our work was to evaluate in-hospital and long-term outcomes in the group of elderly AMI patients with CS (≥75 years old). METHODS: We collected data of 157 consecutive AMI patients with CS who underwent percutaneous coronary intervention (PCI) and compared clinical and procedural characteristics and in-hospital and long-term outcomes between patients <75 years and patients ≥75 years old. RESULTS: There were 58 patients (36.9%) with age ≥75 years and 99 patients (63.1%) with age <75 years. Patients were followed up for an average period of 34 months (range 5-69). In-hospital and long-term mortality was significantly higher in the older group (55 vs. 25%, P < 0.0001; and 62.1 vs. 37.3%, P = 0.005, respectively). Multivariate predictors of in-hospital mortality were age ≥75 years (hazard ratio 1.81, 95% CI 1.006-3.27, P = 0.04) and PCI failure (hazard ratio 2.67, 95% CI 1.34-5.307, P = 0.005), whereas, the only multivariate predictor of long-term mortality was PCI failure (hazard ratio 2.88, 95% CI 1.52-5.46, P = 0.001). Age ≥75 years showed only a trend toward statistical significance (hazard ratio 1.62, 95% CI 0.96-2.76, P = 0.07). CONCLUSIONS: In elderly AMI patients with CS, PCI can be performed with an acceptable risk that seems lower than that reported in most previous studies.
Authors: Patrick Biston; Cesar Aldecoa; Jacques Devriendt; Christian Madl; Didier Chochrad; Jean-Louis Vincent; Daniel De Backer Journal: Intensive Care Med Date: 2013-10-17 Impact factor: 17.440
Authors: Sang Yup Lim; Eun Hui Bae; Joon Seok Choi; Chang Seong Kim; Seong Kwon Ma; Youngkeun Ahn; Myung Ho Jeong; Weon Kim; Jong Shin Woo; Young Jo Kim; Myeong Chan Cho; Chong Jin Kim; Soo Wan Kim Journal: J Korean Med Sci Date: 2013-07-03 Impact factor: 2.153
Authors: Eva Steinacher; Felix Hofer; Niema Kazem; Andreas Hammer; Lorenz Koller; Irene Lang; Christian Hengstenberg; Alexander Niessner; Patrick Sulzgruber Journal: J Pers Med Date: 2022-07-22